Resources & Insights

6 Things to Watch For During Open Enrollment

September 13, 2016
Scott McGraw
CCIG’s Scott McGraw

So apparently Americans are likely to spend more time planning their next vacation than really digging into the nitty-gritty of their health benefit choices during open enrollment periods at work.

Bad move, right? What are the consequences of this?

They’re rather serious, actually, starting with the fact that your employees are likely to make choices that ultimately could end up costing them more than they save.

In the spirit of helping everyone make better choices, what follows are six things that you – and your workforce – should expect during open enrollment this time around:

1. Premiums will go up. Just how much will vary depending on any number of things, but the average cost of a policy will increase by 6 percent or so in 2017 for employees, according to the National Business Group on Health, a Washington, D.C.-based organization that represents large employers.

Employers themselves should expect their own expenses to rise by roughly the same amount.

As is typical, drug costs, the sickest claimants and medical inflation in general are all driving premiums up.

2. HSAs will become even bigger. More than half of the employers surveyed by the NBGH said they plan to offer these high-deductible plans as an option or to fully replace their coverage with an HSA. Dollars saved through one of these tax-advantaged health savings accounts can be used to pay for qualified health-care costs.

Maximum out-of-pocket costs are $6,550 for individuals and $13,100 for families this year with an HSA.

You and your employer can contribute up to $3,350 to your HSA in 2016 if you have individual coverage, or $6,750 for family plans. If you’re at least 55, you can kick in a catch-up contribution of $1,000.

3. More cost-sharing. More consumer cost-sharing is a trend in all forms of health insurance, whether it’s employer-sponsored, ObamaCare or government programs like Medicare or Medicaid. Cost-sharing refers to the amount consumers have to pay out-of-pocket for their care. This includes deductibles, copays and coinsurance.

Cost-sharing helps reduce costs in two ways. Consumers contribute more of their own dollars and they use fewer health care services, because they bear more of the costs.

4. New kinds of controls on spending will arrive on the scene. Specialty drugs to fight cancer or hepatitis C can cost tens or hundreds of thousands of dollars per patient. Hoping to reign in those expenses, nine of 10 employers told the NGBH they plan to install programs to manage specialty-drug costs.

These programs could include shifting drug coverage to large pharmacy benefit firms, which can leverage their size to squeeze better prices from manufacturers.

Another new cost-control approach: infusing drugs at patients’ homes rather than in hospitals.

5. The rise of telemedicine. Delivering healthcare to remote locations is hardly a new concept. But broadband and internet access is more common than ever. Improvements in wearable devices and portable diagnostic technologies have made it possible to do more from the patient’s home. Also, smartphones and associated mobile applications have become available to almost everyone. No wonder nine out of 10 large employers plan to offer telehealth services next year in states that allow it, up from 70 percent this year.

6. A greater focus on getting well. More than eight in 10 large employers already have programs in place to help their workers stop smoking, lose weight or make other lifestyle or behavioral changes. A survey by the Kaiser Family Foundation found that more than 3 in 10 include a financial incentive for completing tasks or programs, such as health-risk assessments and biometric screenings. For the year ahead, employees can expect to see more rewards for participation that will help lower their insurance premiums.

Scott McGraw is Vice President of CCIG’s Employee Benefits division. Reach him at 720-330-7924 or

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